Information Collection

No Wrong Door System Management Tool-State and Local Level

IC 234839 under ICR 202204-0985-001 · OMB 0985-0062.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
No Wrong Door System Management Tool-State and Local Level	Form and Instruction
NWD System Management Tool 0062 NWD System Management Tool Ext 2022.pdf	Form and Instruction
NWD System Management Tool 0062 NWD System Management Tool Ext 2022.pdf	Form and Instruction
NWD ADRC COVID 0062 NWD_ADRC_COVID_Grant_Second Semi Annual Report.pdf	Form and Instruction
NWD ADRC COVID 0062 NWD_ADRC_COVID_Grant_Second Semi Annual Report.pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	NA	NWD System Management Tool	0062 NWD System Management Tool Ext 2022.pdf		Yes	Yes	Fillable Fileable Signable
Form and Instruction	NA	NWD ADRC COVID	0062 NWD_ADRC_COVID_Grant_Second Semi Annual Report.pdf		Yes	Yes	Fillable Fileable Signable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 265

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	530	-1,574	2,104
Annual IC Time Burden (Hours)	5,060	-3,020	8,080
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.